Threat-related automatic associations in socially anxious adolescents

Threat-related automatic associations are assumed to play an important role in the development and maintenance of social anxiety. We tested whether threat-related automatic associations are already evident in high socially anxious adolescents, by comparing a group of adolescents (age 12–15) with subclinical levels of social anxiety (n = 170) to a group of low socially anxious adolescents (n = 193). We used a single-target implicit association test to measure threat-related automatic associations to social cues. Results showed that indeed in high socially anxious adolescents social cues automatically elicited relatively strong threat-related associations. Supporting the relevance of differentiating between automatic and more explicit measures, both automatic and explicit associations were independently associated with adolescents’ level of self-reported social anxiety. The present pattern of findings is not only consistent with the view that automatic and more deliberate threat-related associations are both involved in the etiology of social-anxiety symptoms, but also suggest that both types of associations are proper targets for early intervention programs.     

Differentiating between memory and interpretation biases in socially anxious and nonanxious individuals

Although individual cognitive biases toward threat in social anxiety are well established, few studies have examined the manner in which cognitive biases work in conjunction. In the present study, socially anxious ( n = 54 ) and nonanxious ( n = 58 ) individuals read 10 passages consisting of positive social or evaluative, negative social or evaluative, and neutral content and completed two cognitive tasks assessing memory of factual details and interpretation immediately and after 48 h. Socially anxious and nonanxious individuals did not differ in their memory for details presented in the passages. However, they made less positive and more negative interpretations of details included in the passages, particularly in positive passages that were self-relevant and particularly in positive passages after the delay. After including depression, state anxiety, and trait anxiety as covariates, biased interpretation of positive passages after the time delay remained significant, but biased interpretation of the self-relevant, positive passages did not. It is concluded that socially anxious individuals are characterized by accurate memory of threatening, factual material, but that they impose a biased interpretation upon that material, especially after some time has passed.     

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.     

Communication and social skills in socially anxious and nonanxious individuals in the context of romantic relationships

This study examined differences between socially anxious and nonanxious individuals' ability to use effective communication skills and social skills in the context of romantic relationships. Socially anxious (n = 13) and nonanxious (n = 14) individuals and their romantic partners were videotaped while participating in 10-minute neutral, negative, and pleasant conversations. Regardless of the type of conversation in which they were involved, socially anxious individuals demonstrated impairment in 10 of the 11 social skill variables assessed. In negative conversations, socially anxious individuals displayed more "very negative" behaviors than nonanxious individuals, and across all conversations they displayed fewer "positive" behaviors than nonanxious individuals. Partners of socially anxious and nonanxious individuals did not differ in their communication quality. The results suggest that social anxiety is associated with deficits in relationship maintenance behavior and call for the completion of a larger study examining the interpersonal consequences of social anxiety.     

Affective primes suppress attention bias to threat in socially anxious individuals

Anxious individuals show an attention bias towards threatening information. However, under conditions of sustained environmental threat this otherwise-present attention bias disappears. It remains unclear whether this suppression of attention bias can be caused by a transient activation of the fear system. In the present experiment, high socially anxious and low socially anxious individuals (HSA group, n=12; LSA group, n=12) performed a modified dot-probe task in which they were shown either a neutral or socially threatening prime word prior to each trial. EEG was collected and ERP components to the prime and faces displays were computed. HSA individuals showed an attention bias to threat after a neutral prime, but no attention bias after a threatening prime, demonstrating that suppression of attention bias can occur after a transient activation of the fear system. LSA individuals showed an opposite pattern: no evidence of a bias to threat with neutral primes but induction of an attention bias to threat following threatening primes. ERP results suggested differential processing of the prime and faces displays by HSA and LSA individuals. However, no group by prime interaction was found for any of ERP components.     

Peer behavior toward socially anxious adolescents: classroom observations

This study focused on the relation between adolescents' social anxiety and the way they are treated by classmates. The link between class behavior during oral presentations and the social anxiety of the speakers was investigated. Social anxiety was measured both as a trait variable and as manifest in two state anxiety characteristics. A group of 55 students from Grades 8 and 9 were selected to participate in the study. Class behavior during their presentations was rated by the students themselves, their teacher, and an independent observer. Results showed that negative class behavior was related to social anxiety, particularly when behavior was rated by the independent observer. The data suggested that this negative social outcome is related to longer lasting social interactions in the classroom and not to specific state anxiety characteristics.     

Impact of rumination versus distraction on anxiety and maladaptive self-beliefs in socially anxious individuals

A large body of experimental evidence has demonstrated the adverse effects of rumination on depressive mood and cognitions. In contrast, while prominent models of social phobia (Clark & Wells, 1995; Rapee & Heimberg, 1997) have proposed rumination as a key maintaining factor, the effects of rumination in social anxiety have not been extensively explored. In a sample of (N = 93) undergraduates, this study investigated the impact of rumination versus distraction following a social-evaluative task on anxiety and another key component of social phobia: maladaptive self-beliefs. Relative to distraction, rumination maintained anxiety in both high and low socially anxious individuals, and maintained unconditional beliefs in high socially anxious individuals. The results support models of social phobia and also suggest important theoretical extensions. Implications for the treatment of social anxiety are discussed.     

Facilitating a benign interpretation bias in a high socially anxious population

Previous research has shown that high socially anxious individuals lack the benign interpretation bias present in people without social anxiety. The tendency of high socially anxious people to generate more negative interpretations may lead to anticipated anxiety about future social situations. If so, developing a more benign interpretation bias could lead to a reduction in this anxiety. The current study showed that a benign interpretation bias could be facilitated (or 'trained') in a high socially anxious population. Participants in the benign training groups had repeated practice in accessing benign (positive or non-negative) interpretations of potentially threatening social scenarios. Participants in the control condition were presented with the same social scenarios but without their outcomes being specified. In a later recognition task, participants who received benign interpretation training generated more benign, and less negative, interpretations of new ambiguous social situations compared to the control group. Participants who received benign training also predicted that they would be significantly less anxious in a future social situation than those in the control group. Possible implications of the findings for therapeutic interventions in social phobia are discussed.     

Impact of anticipatory processing versus distraction on multiple indices of anxiety in socially anxious individuals

In models of social phobia, anticipatory processing before a social-evaluative event is a key maintaining factor for the disorder. This study investigated the impact of anticipatory processing versus distraction before a social-evaluative task on affective (self-reported anxiety), psychophysiological (skin conductance), cognitive (self-reported maladaptive self-beliefs) and behavioural (in-situation performance) responses of participants. High and low socially anxious undergraduates were randomly allocated to either an anticipatory processing or distraction condition, and then completed an impromptu speech task. Relative to distraction, anticipatory processing increased self-reported anxiety in all participants, and increased skin conductance and the strength of conditional and high standard beliefs in the high (but not low) socially anxious participants. Unconditional beliefs were not affected. For high socially anxious individuals, anticipatory processing was also indirectly associated with poorer speech performance by increasing self-reported anxiety. Anticipatory processing appears to have multiple adverse effects in socially anxious individuals.     

Memory and interpretation of visual representations of threat in socially anxious and nonanxious individuals

The present study was designed to replicate and extend results reported by Brendle and Wenzel (Behav. Res. Ther. 42 (2004) 155), who found that socially anxious individuals accurately recalled threat-relevant information but subsequently imposed a biased interpretation upon that same material, using more ecologically valid stimuli. Socially anxious (n=37) and nonanxious (n=47) individuals viewed two positive, two negative, and two neutral video vignettes and completed two cognitive tasks assessing memory and interpretation of factual details immediately and after 48 h. Similar to the results reported by Brendle and Wenzel (2004), socially anxious and nonanxious individuals did not differ in their memory for details that had been presented in the vignettes. However, socially anxious individuals made more negative interpretations of details included in the vignettes than nonanxious individuals, although unlike Brendle and Wenzel (2004), they did not demonstrate the tendency to make less positive interpretations. It is concluded that socially anxious individuals are characterized by interpretation biases when presented with threat-relevant information, and there is no evidence to suggest that they are characterized by memory biases for threat-relevant information.     

When the heat is on: romantic partner responses influence distress in socially anxious women

This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed.     

Gaze direction differentially affects avoidance tendencies to happy and angry faces in socially anxious individuals

Increasing evidence indicates that eye gaze direction affects the processing of emotional faces in anxious individuals. However, the effects of eye gaze direction on the behavioral responses elicited by emotional faces, such as avoidance behavior, remain largely unexplored. We administered an Approach-Avoidance Task (AAT) in high (HSA) and low socially anxious (LSA) individuals. All participants responded to photographs of angry, happy and neutral faces (presented with direct and averted gaze), by either pushing a joystick away from them (avoidance) or pulling it towards them (approach). Compared to LSA, HSA were faster in avoiding than approaching angry faces. Most crucially, this avoidance tendency was only present when the perceived anger was directed towards the subject (direct gaze) and not when the gaze of the face-stimulus was averted. In contrast, HSA individuals tended to avoid happy faces irrespectively of gaze direction. Neutral faces elicited no approach-avoidance tendencies. Thus avoidance of angry faces in social anxiety as measured by AA-tasks reflects avoidance of subject-directed anger and not of negative stimuli in general. In addition, although both anger and joy are considered to reflect approach-related emotions, gaze direction did not affect HSA's avoidance of happy faces, suggesting differential mechanisms affecting responses to happy and angry faces in social anxiety.     

Cognitive appraisal mediating relationship between social anxiety and internet communication in adolescents

Research suggests that people with high social anxiety trait may be more inclined to interact through computer-mediated communication (CMC). The psychological underpinnings of this inclination however remained unclear. The present research thus examines if cognitive appraisal bias (i.e. heighten estimation of social risk and deflated self-efficacy) would mediate the relationship between social anxiety and one’s perception of CMC attributes, contributing to a differential pattern of responses in CMC use. Four hundred and ten adolescents aged 12-18 years completed a set of self-reported measures tapping social anxiety trait, cognitive appraisals, perception of CMC attributes, and pattern of CMC social responses. Structural equation modeling lent support to the mediating role of the cognitive appraisal factors. Those with higher social anxiety trait would attach higher self-relevance to the CMC attributes, and engage in a more socially-involved pattern of interpersonal responses in CMC. Implications of these findings are discussed.     

Letting go of yesterday: Effect of distraction on post-event processing and anticipatory anxiety in a socially anxious sample

According to cognitive models, post-event processing (PEP) is a key factor in the maintenance of social anxiety. Given that decreasing PEP can be challenging for socially anxious individuals, it is important to identify potentially useful strategies. Although distraction may help to decrease PEP, the findings have been equivocal. The primary purpose of this study was to examine whether a brief distraction period immediately following a speech would lead to less PEP the next day. The secondary aim was to examine the effect of distraction following an initial speech on anticipatory anxiety for a second speech, via reductions in PEP. Participants (N = 77 undergraduates with elevated social anxiety; 67.53% female) delivered a speech and were randomly assigned to a distraction, rumination, or control condition. The following day, participants reported levels of PEP in relation to the first speech, as well as anxiety regarding a second, upcoming speech. As expected, those in the distraction condition reported less PEP than those in the rumination and control conditions. Additionally, distraction following the first speech was indirectly related to anticipatory anxiety for the second speech, via PEP. Distraction may represent a potentially useful strategy for reducing PEP and other maladaptive processes that may maintain social anxiety.     

Social anxiety disorder in childhood and adolescence: descriptive psychopathology

Although the presentation of social anxiety disorder (SAD) in adults is well documented, less is known about its clinical manifestation in children and adolescents. To date, most studies have included combined samples of children and adolescents despite the fact that this age range represents an extensive period of growth and development. This study compares and contrasts the clinical presentation of SAD among children (ages 7-12) and adolescents (ages 13-17). One hundred and fifty children (n=74) and adolescents (n=76) with a primary diagnosis of SAD participated in the study. The assessment battery included clinical ratings and behavioral observation as well as parental and self-report. The results indicate that, although the symptom presentation of children and adolescents with primary SAD shares many features, children tend to present with a broader pattern of general psychopathology, while adolescents have a more pervasive pattern of social dysfunction and may be more functionally impaired as a result of their disorder. These findings suggest that interventions for SAD need to carefully consider clinical presentation of the disorder as it manifests in childhood and adolescence.     

Subtyping children and adolescents with loss of control eating by negative affect and dietary restraint

OBJECTIVE: Research suggests that subtyping adults with binge eating disorders by dietary restraint and negative affect predicts comorbid psychopathology, binge eating severity, and treatment outcome. Little research has explored the validity and clinical utility of subtyping youth along these dimensions. METHOD: Children (aged 8-18 years) reporting loss of control eating (n=159) were characterized based upon measures of dietary restraint and negative affect using cluster analysis, and then compared regarding disordered eating attitudes and behaviors, and parent-reported behavior problems. RESULTS: Robust subtypes characterized by dietary restraint (n=114; 71.7%) and dietary restraint/high negative affect (n=45; 28.3%) emerged. Compared to the former group, the dietary restraint/high negative affect subtype evidenced increased shape and weight concerns, more frequent binge eating episodes, and higher rates of parent-reported problems (all ps<0.05). CONCLUSION: Similar to findings from the adult literature, the presence of negative affect may mark a more severe variant of loss of control eating in youth. Future research should explore the impact of dietary restraint/negative affect subtypes on psychiatric functioning, body weight, and treatment outcome.     

Threat interpretation in anxious children and their mothers: comparison with nonclinical children and the effects of treatment

Interpretation biases towards threat play a prominent role in cognitive theories of anxiety, and have been identified amongst highly anxious adults and children. Little is known, however, about the development of these cognitive biases although family processes have been implicated. The current study investigated the nature of threat interpretation of anxious children and their mothers through (i) comparison of a clinic and non-clinic population, (ii) analysis of individual differences; and (iii) pre- and post-treatment comparisons. Participants were 27 children with a primary anxiety disorder and 33 children from a non-clinic population and their mothers. Children and mothers completed self-report measures of anxiety and indicated their most likely interpretation of ambiguous scenarios. Clinic and non-clinical groups differed significantly on measures of threat interpretation. Furthermore, mothers' and children's threat interpretation correlated significantly. Following treatment for child anxiety, both children and their mothers reported a reduction in threat interpretation.     

Episodic future thinking in children compared to adolescents

Episodic thinking involves the ability to re-create past and to construct future personal events, which contain event-specific (episodic) and general (semantic) details. The richness of episodic thought for past events improves as children move into adolescence. The current study aims to examine changes in episodic future thinking and to establish the cognitive underpinning of these changes. Typically developing children (n = 14) and adolescents (n = 15) were tested using an adapted version of the Child Autobiographical Interview (CAI) that required generation of past and future personally relevant events. Relational memory and executive skills were also examined. Significant developmental gains were found in richness of events recall across temporal directions (past and future) and across different types of details (episodic and semantic). Developmental gains in richness of past events were also shown to correspond to developmental gains in generation of future events. Moreover, developmental changes in relational memory and (to a lesser extent) executive functions were found to relate to increases in the amount of episodic (but not semantic) details provided. Our study highlighted the similarities between past and future episodic thinking in typically developing children and adolescents. It also raises a possibility that children with developmental and neurological disorders with impaired relational memory and/or executive skills may be at risk of difficulties with episodic thinking.     

Interpretations and judgments regarding positive and negative social scenarios in childhood social anxiety

The present study extended our understanding of cognitive biases in childhood social anxiety. A non-clinical sample of 11-13-year olds completed social anxiety and depression scales and were presented with scenarios depicting positive and mildly negative social events. Social anxiety was associated with tendencies to interpret positive social events in a discounting fashion, to catastrophize in response to mildly negative social events, and to anticipate more negative emotional reactions to the negative events. Implications for understanding and treating social anxiety are discussed.     

Spider fear and covariation bias in children and adolescents

Covariation bias can be defined as phobic people's tendency to overestimate the association between fear-relevant stimuli and negative outcomes. The current article presents two studies that examined this type of cognitive bias in children and adolescents aged 8-16 years. Study 1 was concerned with a thought experiment during which youths (N=150) were asked to imagine that they participated in an experiment during which they had to view a series of pictures showing spiders, guns, and flowers, that were occasionally followed by a negative outcome (i.e., a mild electric shock). Participants were asked to estimate the relation between each type of picture and the negative outcome. The results indicated that youths with higher levels of spider fear displayed a specific tendency to relate spider pictures to a negative outcome. In Study 2, youths (N=220) actually participated in a computer game during which they were confronted with pictures of spiders, guns, and flowers, each of which was equally often followed by a negative (i.e., losing candy), positive (i.e., winning candy), or neutral outcome. After the game, participants had to estimate the relation between each type of picture and various outcomes. It was found that youths with higher levels of spider fear estimated more negative and less positive outcomes in relation to spider pictures. Taken together, these findings provide support for a fear-related covariation bias in youths. Further developmental analyses indicated that this type of cognitive bias seems to be more consistently present among adolescents than among children.